Applied Sensorimotor Research Laboratory – ENS 213

The goal of my research is to identify mechanisms underlying psychomotor responses to stress and pain, and to apply this knowledge to the prevention and treatment of chronic musculoskeletal pain disorders. We use a variety of neurophysiologic techniques to investigate how the central nervous system responds to stress and pain in healthy individuals and clinical populations. We also conduct clinical studies to investigate risk factors and novel treatment strategies for chronic pain, with a specific focus on spine pain and headache.

Primary experimental techniques include surface and intra-muscular electromyography (EMG), functional magnetic resonance imaging (fMRI), and quantitative sensory testing (QST).  Primary behavioral approaches include motor skill retraining, motivational interviewing, cognitive behavioral skills training, and pain neuroscience education. Integrated mind-body approaches in physical rehabilitation are a primary focus of the lab.

Katrina Monroe PT, PhD

Professor[email protected]619-594-5553ENS 126

Facility

Applied Sensorimotor Research Laboratory (ASML). The ASML comprises 470 sq. ft. of dedicated research space in the Exercise and Nutritional Sciences Building (Room 213) at SDSU.  The ASML houses research equipment used for quantitative sensory testing, electromyography, and clinical assessment of neuromuscular impairment and functional performance.  Private clinical examination space and a conference area for research meetings are also available. Four shared computer workstations are used for data entry, processing, and analysis by students and research assistants.

Additionally, the ASML maintains active collaborations with other institutions and clinics in the local community, including:

Academic Partnerships

Center of Excellence for Stress and Mental Health (CESAMH), Veterans Administration San Diego Health System (VASDHS). The CESAMH mission is to improve the health and well-being of Veterans by combining research, education, and clinical care into a single program leveraging the expertise of clinical and academic affiliates to help reduce the time from scientific discovery to clinical implementation. CESAMH supports basic research into the neural mechanisms of trauma-related health problems to develop and test novel preventive and treatment strategies.

UCSD Center for Functional Magnetic Resonance Imaging (CFMRI). The Keck Center is approximately 7,000 square feet and houses two research-dedicated GE 3T Signa Infinity MRI scanners (GE MR750) with Excite System for human studies. The systems are equipped for state-of-the-art high-resolution structural and dynamic imaging.

SDSU HealthLINK Center. Funded by a $10 million endowment from the National Institute of Minority Health and Health Disparities, SDSU HealthLINK is a multi-college effort to help SDSU and its auxiliary SDSU Research Foundation build infrastructure to support population health and health disparities research.

SDSU-UCSD Joint Doctoral Program (JDP) in Public Health. A Ph.D. in Public Health with a concentration in Health Behavior is offered by the joint faculties of the Division of Health Promotion, School of Public Health, and the Department of Family and Preventive Medicine, School of Medicine at UCSD. Dr. Maluf serves as a faculty mentor for JDP PhD students who have an interest in physical rehabilitation research.

Clinical Partnerships

Family Health Centers of San Diego. FHCSD is a Federally Qualified Health Center with 5 physical therapy clinics in the San Diego region that serve a socioeconomically and ethnically diverse patient population. FHCSD is a clinical partner site for the GOALS study, a clinical trial investigating the efficacy of an adapted cognitive-behavioral physical therapy telehealth intervention for Latinos/Latinas with chronic spine pain.

Physical Rehabilitation Network of La Jolla/ UTC. PRN – La Jolla/UTC is a private outpatient clinic staffed by 5 full-time physical therapists who specialize in the evaluation and treatment of musculoskeletal pain conditions. PRN is a clinical partner site for an observational study of the role of patient-provider communication on therapeutic alliance and clinical outcomes of chronic pain rehabilitation.

Lab Members

Project Managers

• Yessenia Hernandez (SDSU)
• Cristina Rangel Batalla (VASDHS)

Research Physical Therapist

• Cassandra Rodriguez (SDSU/FHCSD)
• Patrick Cummings (FHCSD)

Research Assistants

• Valerie De La Paz (SDSU)
• Alejandro Moreno (SDSU)
• Chelsea Contreras-Valencia (SDSU)

PhD Students

• Aaron Parr (SDSU/UCSD Joint Doctoral Program in Public Health)
• Patricia Dionicio (SDSU/UCSD Joint Doctoral Program in Public Health)

Current Research Projects

• National Institutes of Health (NIMHD) U54 MD012397 (2018-2023). SDSU HealthLINK Center for Transdisciplinary Health Disparities Research. This project aims to improve infrastructure at SDSU and its partner organizations to advance minority health and health disparities research among racially/ethnically diverse and lower-income populations using a community-engaged transdisciplinary research approach. Maluf Role: Center Co-Investigator (MPIs: Dr. Guadalupe Ayala, Dr. Kristen Wells) and Project Co-Principal Investigator (Co-PI: Dr. Sara Gombatto) for $1.6M clinical trial, Cognitive Behavioral Based Physical Therapy for Latinos with Chronic Spine Pain in partnership with Family Health Centers of San Diego.

Completed Studies

• National Institutes of Health (NCMRR) F31 HD101274 (2019-2022). Role of Patient-Provider Communication on Clinical Outcomes of Chronic Pain Rehabilitation. This fellowship provides pre-doctoral training for a PhD student in the SDSU/UCSD Joint Doctoral Program in Public Health.  The dissertation study uses mixed methods approaches to examine the relationship between communication practices, patient-provider therapeutic alliance, and clinical outcomes in patients referred to physical therapy for the management of chronic pain. Maluf Role: Faculty mentor (Fellow: Chelsea Chapman)
• National Institutes of Health (NINDS) R21 NS109852 (2019-2022). Imaging Central and Peripheral Impairments in Chronic Post-Traumatic Headache with Comorbid Neck Pain. This collaborative project between SDSU, UCSD, and VA San Diego uses magnetic resonance imaging and quantitative sensory testing to identify markers of brain and muscle dysfunction contributing to post-traumatic headache in veterans with mild traumatic brain injury, with the long-term goal of identifying biomarkers of clinical phenotypes to better inform treatment decisions. Maluf Role: Principal Investigator (Co-MPIs: Dr. Dawn Schiehser, Dr. Bahar Shahidi)
  >>>NOW RECRUITING Veterans with Chronic Headache and/or Neck Pain
• National Institutes of Health (NIAMS) R01 AR056704 (2010-2015). Stress-Evoked Muscle Activity in Occupational Myalgia. The goal of this prospective cohort investigation was to identify stress-evoked muscle activity and other modifiable physical, psychological, and neurophysiolgical risk factors for the development of chronic neck pain in a high-risk population of office workers. Maluf Role: Principal Investigator

DPT Student Doctoral Projects

• DPT Class of 2022. Tristen Giron-Flores, Morgan Hatch, Joseph Marshall, Nina Sao, Travis Webb. Effects of Blood Flow Restriction training on exercise induced hypoalgesia.
• DPT Class of 2021. Robyn Bursch, Jenny Carmel, Ashleigh Carranza, Kelsey Cooper, Jayme Lee, Colleen O’Connor. Greater severity and functional impact of post-traumatic headache in Veterans with comorbid neck pain following traumatic brain injury.
• DPT Class of 2020. David Dellaserra, Matt Friedman, Paige Kettenburg, Brenna Lewman, Sydney Stuber, Jaime Zinn. Factors predicting non-adherence to Physical Therapy referral for spine pain in a Federally Qualified Health Center.
• DPT Class of 2019. Rachel De Los Santos, Ryan Kirschenmann, Ethan Morgan, Sonnen Olson, Jenny Ross, Samantha Stack. Association between disrupted sleep and pain modulation in adults with chronic spine pain: A pilot study.
• DPT Class of 2018. Christina Crossen, Jessica Herman, Marie Krouse, Victor Larios, Elana Miller. Sedentary behavior and pain-related anxiety is associated with reduced mechanical pain tolerance in healthy pain-free adults.